Retinal vein occlusion

Definition

Retinal vein occlusion is a blockage of the small veins that carry blood away from the retina. The retina is the layer of tissue at the back of the inner eye that converts light images to nerve signals and sends them to the brain.

Alternative Names

Causes

Retinal vein occlusion is most often caused by hardening of the arteries (atherosclerosis) and the formation of a blood clot.

Blockage of smaller veins (branch veins or BRVO) in the retina often occurs when retinal arteries that have been thickened or hardened by atherosclerosis cross over and place pressure on a retinal vein.

Blood tests to look for a clotting or blood thickening (hyperviscosity) problem (in patients under age 40)

The health care provider should closely monitor any blockage for several months. Many harmful effects, such as glaucoma, take 3 or more months to develop after the occlusion.

Treatment

Many people will regain vision, even without treatment. However, vision rarely returns to normal. There is no way to reverse or open the blockage.

You may need treatment to prevent another blockage from forming in the same or the other eye.

It's important to manage diabetes, high blood pressure, and high cholesterol levels. Some patients may receive aspirin or other blood thinners.

Treatment for the complications of retinal vein occlusion may include:

Focal laser treatment, if macular edema is present

Injections of anti-vascular endothelial growth factor (anti-VEGF) drugs into the eye. These drugs may block the growth of new blood vessels that can cause glaucoma. This treatment is still being studied.

Laser treatment to prevent the growth of new, abnormal blood vessels that leads to glaucoma

Outlook (Prognosis)

It is important to properly manage complications, such as macular edema and glaucoma. However, having either of these complications is more likely to lead to a poor outcome.

Possible Complications

Glaucoma

Partial or complete vision loss in the affected eye

When to Contact a Medical Professional

Call your health care provider if you have sudden blurring or vision loss.

Prevention

Retinal vein occlusion is a sign of a general blood vessel (vascular) disease. The same measures used to prevent other blood vessel diseases, such as coronary artery disease, may decrease the risk of retinal vein occlusion.

These measures include:

Eating a low-fat diet

Getting regular exercise

Maintaining an ideal weight

Not smoking

Aspirin or other blood thinners may help prevent blockages in the other eye.

Controlling diabetes is important in general, and it may also be helpful for preventing retinal vein occlusion.